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When it comes to health care reform, look to the states, not the federal government 


There’s much talk in Washington about health care, but far less action. By contrast, some state capitals across the country are pursuing bolder, more interesting reform.

It’s true that, at the federal level, the administration has expanded use of short-term, limited duration plans by allowing policyholders to use them for up to three years, rather than the previous restriction of three months. The move has proven wildly popular with consumers.

And the Trump administration in June implemented a rule change that provided greater opportunity for small employers to offer their employees more health coverage choices. These reforms to health reimbursement arrangements will allow Americans to purchase their own insurance plans using employer contributions to their HRAs starting Jan. 1, 2020. Previously, HRAs could be used only to offset out-of-pocket expenses.

But reforms that address some of our biggest problems in health care are unlikely to come from Washington anytime soon. Meanwhile, several states are forging ahead with reforms to expand access to care.

Florida Gov. Ron DeSantis recently signed into law a repeal of most elements of the state’s certificate-of-need law, which restricts the supply of care by limiting the number of providers permitted by the government to operate in a certain area.

Florida lawmakers recognized the deleterious effects their certificate-of need-law had on the supply of care — and by extension, its costs — and took action. While Florida only recently repealed most of its certificate of need law, several proposed health care facilities, including hospitals, are already slated for construction as a result of this reform.

Jacksonville is already seeing an expansion of their health care systems. Henry Grady, who directs health care investment for SunTrust Bank, and manages the bank’s relationships with providers in North Florida, is very optimistic about the state’s repeal of its certificate-of-need law.

“I think that [the repeal] has accelerated a lot of things … that might’ve been on the drawing board two, three, five years out, upstream,” Grady said. He’s referring to the future growth of care providers and facilities.

Before, providers had to grapple with strict political impediments to serving Florida patients. Now, they’re free to navigate the market in order to get care to where it’s needed most.

In the expanding field of telemedicine, patients have the opportunity to receive medical care remotely, through a smartphone, tablet or laptop. Virginia Gov. Ralph Northam and the General Assembly recognized the potential of this growing technology and in March enacted a measure that would reduce barriers for Virginians to access telemedicine services. Florida followed suit soon after.

These are measures that will decrease wait times for care, reduce costs and close the distance between provider and patient.

This is why it’s so important for more states to pick up the torch and remove their own barriers to care. Lawmakers in Arkansas, for example, have passed measures to reform their scope-of-practice laws, a move that would allow trained and certified nurse practitioners and physician assistants greater flexibility to provide care to patients.

These measures would help these states lead the way in reducing costs and wait times – not to mention closing the geographic distance between health care professionals and rural patients. 

Some see the solution to our health care system in the form of a top-down, all-encompassing federal approach. Nevertheless, that isn’t the solution envisioned by the American people and their state representatives carrying the ball of reform.

For them, the solution is local — and so far, very effective.

Our leaders and other patient advocacy stakeholders should embrace these state reform efforts and ask a simple question – what can I do to expand and accelerate this kind of reform?

David Barnes is a policy manager at Americans for Prosperity

Tags Ron DeSantis

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